Project Title: Application Date:

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1 PCC District Student Council The Green Initiative Fund Funding Application Due to Kendi Esary by November 30th, 2015 Campus Address: CA Student Union Room Project Title: Application Date: What section(s) and objective(s) of PCC s Climate Action Plan does this project meet? Transportation Food Agriculture & Natural Resources Community Outreach Buildings & Energy Consumption & Solid Waste Sustainability in Education Tracking Progress & Financing Sponsoring Organizations (must be part of campus department): Mailing Address of Primary Contact: Primary Contact Person: Title: Phone: E- mail: Student Staff Faculty Secondary Contact Person: Title: Phone: E- mail: Student Staff Faculty Project Start Date: Project End Date (All projects must be complete by June 15, 2017): By signing below, I hereby support and authorize this grant request and will support the students and staff to ensure its completion. Project Advisor Signature: X Campus President s Signature: X Facilities Management Services (if project requires such): X

2 Please complete all components of application Is this a request for additional funds for an existing TGIF Project? YES NO Which Campuses will be served by your project? HAVE YOU Rock Creek. Cascade Southeast Center Sylvania Central Workforce Training Center (CLIMB) District- Wide Other Found an advisor and staff member Had someone proof read your application Answered all questions including worksheets Got all the approvals your project would require (Example: Campus administration, Budget and Planning Committee, SLT, SPARC, Green Teams, Facilities Management Services, IT, Sustainability Office, Food Services, Department Chair, Campus Public Relations, etc.) Found the best price for materials needed and/or sourced product using best value approach which considers environmental and social criteria in procurement decision Cited references for material costs PROJECT NARRATIVE (please submit answers to the following questions in a separate document) 1. What is the need this project is addressing? 2. How will your project address the stated need? 3. What are the desired outcomes of your project? 4. What is the timeline for your project? 5. How do the project goals meet the TGIF mission statement and guiding principles (see attached)? 6. How does this project support other sustainability efforts on the campus and help move the college beyond its current programs? 7. What sources of labor will your project use? (For example: if the project has installation and/or on- going operations & maintenance requirements, who will do this task? Estimated amount of time spent on labor? At what cost? Etc. Consider the labor involved in manufacturing and recycling any project materials in addition to the labor at the project campus.) 8. What materials will you need for your proposal? Where do these materials come from and what are the plans for safe disposal of any products or byproducts of your project? 9. How will you measure the success of your project? If this is a request for an existing TGIF project, please answer the following questions: 10. Why do you need additional funding? What happened to the original funding? 11. Is this proposal an expansion of the existing project, or is it a different scope?

3 REQUIRED ATTACHMENTS Please complete attached Budget Worksheet. If you are a student include a letter of support from a staff advisor or administrator. Please note that Facilities Management Services will not necessarily complete any projects funded by the TGIF. Facilities Management Services may take on projects as availability allows, but applicants should plan for alternate personnel, project managers, contractors, etc. Typically, individual proposals seeking funding under TGIF will be awarded a maximum of 25% of the overall TGIF budget. For this round of funding, this translates to $20,000. Requests for funding exceeding this limit will be considered on an exceptional basis and will require justification for funding exceeding the 25% limit. If approved: FINAL REPORT How did you publicize your project? What were the road blocks and barriers? How were students engaged in the process? Success of your initiative or project? Do you anticipate the project will result in GHG emissions reductions? Describe projected cost savings to the college, if any? Due by June 15, 2015

4 The Green Initiative Fund Budget Form Use the spreadsheet below to list all budget items for which funding is being requested. Include cost and total amount for each item requested. Attach additional pages if necessary. Infrastructure (Capital expenses, etc.) Item Cost Request Education (Outreach, publicity etc.) Personnel (Salary/wage, benefits, etc) show detailed break down Total $ Budget Narrative (Please submit answers to the following questions in a separate document.) 1. List all sources of funding (pending and approved) for this project including grants, volunteer efforts, and in kind donations Include: Fund description Date submitted Status or amount received that applies to this proposal 2. Would your project still be viable if it does not receive complete funding from the TGIF? 3. Is your project scalable? 4. What is the minimum amount of funding required for a successful project? 5. If this budget has been on- going or occurred before, please describe the previous year s budgets, including total amount spent and sources of funding. Please also include any justifications for increasing the previous year s budgets and seeking funding from the TGIF as opposed to using only the previous year s funding sources. 6. If you are funded, will your project require ongoing funding? If yes, what is your strategy for sustaining the project after the grant period ends?

5 The Green Initiative Fund (TGIF) Mission Statement and Guiding Principles Mission Statement The Green Initiative Fund (TGIF) provides funding for projects which green our campus and reduce the college s impact on the environment. TGIF allocates funds to projects that increase the amount of renewable energy used on campus, increase energy efficiency, and reduce the amount of waste created by our college. Portions of the fund will support education initiatives and student internships. TGIF is administered through a student majority governance board. Plan of Operation Projects shall support efforts to reduce PCC s impact on the environment. The governance board of TGIF shall take into consideration the fact that PCC is a multi campus institution. Therefore, an effort shall be made to distribute funds in an equitable manner. Projects shall contain publicity, education and outreach components. All necessary written approval by appropriate campus officials shall be obtained prior to consideration. PCC students, staff, and faculty are permitted to submit project proposals, as long as they are under the umbrella of a campus department. Individuals and organizations outside the college are not allowed to submit project proposals. TGIF funding will not support projects that are already mandated by law or college policy. TGIF will only fund projects that are not currently paid for by the college. TGIF is limited in funds and therefore will be more likely to support projects which have secured partial funding via other means. Other means may come from department budgets or outside sources. Preference will be given to projects that demonstrate the greatest reduction of PCC s greenhouse gas emissions and/or resource usage for the least cost. Student participation is encouraged in all projects. Projects shall positively impact both social and environmental sustainability and take into account all impacts. A report will be required upon completion of each project. We will release the report to the public.

6 Item Cost Request Infastructure (Capital Expenses, etc) Education (Outreach, Publicity, etc) Personnel (Salary/Wage, Benefits, etc) - Show Detailed Break Down Total $